Patient-reported symptoms obtained through telephonic nursing services in an oncology disease management program

Autor: Janet L. Espirito, Deb Harrison, M. Clayton, Robyn K. Harrell, Jessica McQueen, Mitra Abdullahpour, J. Russell Hoverman, Melissa Jameson
Rok vydání: 2013
Předmět:
Zdroj: Journal of Clinical Oncology. 31:147-147
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2013.31.31_suppl.147
Popis: 147 Background: Telephonic nursing (RN) outreach was provided as part of an oncology disease management program to provide symptom (sx) management education, assess patient-reported sxs during treatment (tx), and reduce acute care utilization. The Edmonton Symptom Assessment Scale (ESAS) was used to assess sx severity in patients (pts) receiving active chemotherapy. Methods: ESAS scores were obtained at scheduled intervals and documented in the electronic health record for eligible pts receiving chemotherapy between 6/2010-12/2012. Participation was voluntary. Pts were categorized according to cancer diagnosis (dx) and tx setting (early vs. advanced). Repeated measures logistic regression analysis was used to test for differences in ESAS scores between dx and tx settings. Results: 365 pts had 2,198 calls with ESAS scores. Mean age was 53 yrs, 67% female, 33% male. Pts were managed an average of 97 days and received on avg 6 calls/pt. The majority of pts had breast, colon, and non-small cell lung (NSCL) cancer (74%). Of these pts, the most frequent reported sx of any severity other than zero during post-tx calls were for mild/moderate tiredness, appetite, and pain. There was no evidence of a significant difference in the severity of sxs by tx setting in these cohorts; p=NS. One hundred and nine breast, colon, and NSCL pts (40%) received additional unscheduled calls based on sx scores or RN assessment. Outcomes related to acute care utilization are being evaluated. Conclusions: Pt reported sxs obtained through telephonic RN support demonstrated mild/moderate ESAS scores for mainly tiredness, appetite, and pain. This is lower than previously reported in different contexts. Regular RN contact as a supplement to clinic visits may help reduce sx severity. While the ESAS tool is traditionally used for palliative care, in this active tx setting it supported identification of sxs for referrals back to the practice with the goal to reinforce education and avoid acute care utilization. [Table: see text]
Databáze: OpenAIRE
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